RT Journal
A1 Kreitz K, Rovito PF
T1 LAparoscopic roux-en-y gastric bypass in the "megaobese"
JF Archives of Surgery
JO Archives of Surgery
YR 2003
FD July 1
VO 138
IS 7
SP 707
OP 709
DO 10.1001/archsurg.138.7.707
UL http://dx.doi.org/10.1001/archsurg.138.7.707
AB Hypothesis
Laparoscopic Roux-en-Y gastric bypass is a safe and effective procedure in patients with a body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) of 70 or greater.Design
A retrospective analysis of patients with a BMI of 70 or greater who underwent laparoscopic Roux-en-Y gastric bypass by a single surgeon.Setting
A university-affiliated community hospital in Allentown, Pa.Patients
A nonconsecutive series of 9 patients with a BMI of 70 or greater who met traditional criteria for a bariatric procedure.Intervention
Laparoscopic approach to Roux-en-Y gastric bypass with stapled anastomoses.Results
Patient medical records were reviewed for length of stay, complications, operative time, comorbidities, and weight loss. Seven patients were women and 2 were men. Comorbidities included dyspnea on exertion, peripheral edema, arthritis, sleep apnea, hypertension, diabetes mellitus, asthma, hypothyroidism, gastroesophageal reflux disease, peptic ulcer disease, and heart disease. Eight of 9 procedures were successfully completed laparoscopically. One patient was converted to an open procedure. One patient developed a marginal ulcer postoperatively. No other complications occurred. Operative time ranged from 122 to 330 minutes (mean, 203 minutes). Length of stay averaged 1.2 days. Overall weight loss was 49% of excess body weight at 1 year after surgery.Conclusion
Laparoscopic Roux-en-Y gastric bypass is safe and effective in patients with a BMI of 70 or greater.